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WP0042756
Environmental Health - Public
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EHD Program Facility Records by Street Name
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12 (STATE ROUTE 12)
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6220
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2900 - Site Mitigation Program
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WP0042756
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Entry Properties
Last modified
11/19/2024 3:48:26 PM
Creation date
10/18/2022 9:35:50 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
BILLING/PERMITS
RECORD_ID
WP0042756
PE
2905
FACILITY_ID
FA0026861
STREET_NUMBER
6220
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240-
APN
04912002
ENTERED_DATE
11/18/2021 12:00:00 AM
SITE_LOCATION
6220 HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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IF, �S� <br />tSANlOAQUIN <br />'�. ^, <br />COUNTY <br />Greatness grobvs here. <br />Environmental Health Department <br />Monitoring Well/Soil Boring Inspection Report <br />Date: � �Inspector: �S�s ?6Kt <br />Facility Address: 2:?.�� l Z, <br />Well Address: <br />Al P# (�j 4 .Z �-� Well#: <br />Soil Boring#. <br />Drilling Company: A� � c�C G C u <br />Driller Onsite: <br />Consultant: at. V /L,%. CAe G CO <br />Geologist: inn;tL <br />Public Water System Onsite: <br />Domestic Well Onsite: <br />If <br />yes, location and distance:, <br />SAMPLING <br />Holding Temperature: <br />Method: <br />Screening Method:_ <br />Verified Chain of Custody: <br />SPOILS <br />Contamination Noted: <br />If yes, spoils storage Location:. <br />Covered: <br />v- Ito 5 <br />❑ Yes ❑No <br />❑ Yes ❑No <br />❑ Yes ❑No <br />If yes, material: <br />GROUTING or DESTRUCTION Total Depth: <br />Depth to Water: 94 10 lf'v-C;0tft AA-jlr�V <br />Grout Material: lVe <br />Gallons of Grout Used. <br />❑Well Installation ❑Well Destruction <br />:]Boring <br />Boring Installation wring Destruction <br />METHOD USED <br />❑Pressure Grout ❑Over Drill <br />Gravity ❑Tremie ❑Other: <br />Water <br />allons <br />Cement 471b <br />Bas <br />3°�° ftiAix <br />Water <br />allons <br />Cernent 941b <br />Sa s <br />Thickest <br />Thinnest <br />#Bags <br />Thickest <br />Thinnest <br />#bags <br />2,5 <br />5 <br />1 <br />5 <br />10 <br />1 <br />5 <br />10 <br />2 <br />10 <br />20 <br />2 <br />745 <br />15 <br />3 <br />15 <br />30 <br />3 <br />10 <br />20 <br />4 <br />20 <br />40 <br />4 <br />25 <br />50 <br />5 <br />12.5 <br />25 <br />5 <br />30 <br />60 <br />6 <br />15 <br />30 <br />6 <br />35 <br />70 <br />7 <br />17, 5 <br />35 <br />7 <br />40 <br />80 <br />s <br />20 <br />40 <br />s <br />CONSTRUCTION <br />Total Depth: <br />Dri <br />U <br />lling Rig Type: <br />Min 2" Annular EHD Seal Verified: ❑Yes ❑No <br />Screen Length From: To: <br />Filter Pack From: To. <br />Bentonite From. To: <br />Grout From: To. <br />COMPLETION ❑Stove Pipe ❑Christie Box <br />• o �s <br />Pi Y <br />r <br />tt, <br />sian�ct <br />mon <br />MATERIALS/DEVELOPMENT <br />Casing Type: <br />Blank Feet <br />Slot Size: <br />Bags of Cement. <br />Bags Sand/Gravel: <br />Type/Brand of Bentonite: <br />Filter Pack Type/Size. <br />Type of Method: <br />Screen <br />Feet <br />10/16/2017 <br />1868 E. Hazelton Avenue � Stockton, California 95205 � T 209 468-3420 � F 209 464-0138 � www.s►cehd.com <br />��ntonitelOement IVIi� <br />3°�° ftiAix <br />�°�° Nli� <br />Bentonite per 47 lb <br />1.41 <br />2.47 <br />Bentonite per 94 Ib <br />2.82 <br />4.7 <br />i <br />S <br />10/16/2017 <br />1868 E. Hazelton Avenue � Stockton, California 95205 � T 209 468-3420 � F 209 464-0138 � www.s►cehd.com <br />
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